$59Specialist GP consultation · prescription to your nominated pharmacy · quarterly pathology at any collection centre
Phone consult with a Specialist GP to discuss PrEP for HIV prevention. New start? Already on PrEP? GP talks through eligibility, monitoring tests, and ongoing prescription pathways.
PrEP is funded through the PBS for eligible patients. GP discusses what is involved and the testing schedule needed.
Your Specialist GP will call you at your booked time.
How to start PrEP online in Australia
What this page covers. PrEP (pre-exposure prophylaxis) is a daily tablet, taken before potential HIV exposure, that prevents HIV infection when taken as directed. With consistent use, PrEP is more than 99 percent effective at preventing HIV. This page covers how PrEP works, the two dosing options (daily and on-demand), who PrEP is appropriate for, the pre-start checks, the ongoing monitoring schedule, side effects, what PrEP does and does not protect against, and the steps to start PrEP through a Specialist GP at Clinic365.
How PrEP works. PrEP is a tablet that contains two HIV-prevention medications. When the medication is in your system at adequate levels, the virus cannot establish infection if it enters the body. PrEP is taken before exposure (not after) — this is what separates it from PEP (post-exposure prophylaxis), which is started within 72 hours of a possible exposure. For people with ongoing HIV exposure risk, PrEP is more effective and more convenient than relying on PEP after each potential exposure.
How well does PrEP work? With consistent daily use, PrEP is more than 99 percent effective at preventing sexually acquired HIV. The protection level depends on adherence — meaning the medication has to be in your system at the time of exposure. For receptive anal sex, full mucosal protection is reached after about 7 days of daily dosing. For receptive vaginal sex, full protection is reached after about 21 days. This is why a loading-in period before exposure begins matters.
Daily PrEP vs on-demand PrEP. There are two evidence-based dosing schedules. Daily PrEP is one tablet a day, every day, regardless of when sex is happening. On-demand (also called event-based, or "2-1-1") PrEP is 2 tablets between 2 and 24 hours before sex, 1 tablet 24 hours after the first dose, and 1 tablet 48 hours after the first dose. On-demand dosing is currently recommended only for men who have sex with men — for cis women and people with receptive vaginal sex, daily dosing is the only protocol with strong evidence. The Specialist GP discusses which option fits your pattern of risk at the consult.
Who PrEP is for. Australian guidelines recommend PrEP for people at substantial risk of HIV exposure. This includes: men who have sex with men, particularly those who have condomless sex with partners of unknown HIV status; people whose regular partner has HIV and is not virally suppressed; people who inject drugs and share equipment; sex workers; and anyone else whose sexual or other exposure patterns put them at meaningful risk. The Specialist GP works through your situation at the consult to decide whether PrEP is the right option.
Pre-start checks. Before starting PrEP, the Specialist GP arranges several baseline tests: an HIV test (PrEP must not be started in someone with undiagnosed HIV — the resistance risk is significant), a kidney function blood test (creatinine), hepatitis B and hepatitis C status, and a full STI screen. These checks can usually be combined into one pathology referral and most results are back within a few days. PrEP can usually be started the same week as the consult once the HIV result is confirmed.
Window-period considerations before starting PrEP. The HIV test in the pre-start workup must be a recent negative result — PrEP must not be started in someone with undiagnosed early HIV infection. The window period for the standard HIV test (4th-generation antibody/antigen combination) is around 4 to 6 weeks after exposure; the HIV RNA viral load test detects infection earlier (around 7 to 14 days after exposure). If you have had a possible HIV exposure in the past 3 months, the Specialist GP discusses what testing makes sense before starting PrEP. See when to test after exposure for full window-period detail.
Ongoing monitoring. While on PrEP, the standard monitoring schedule is: a quarterly HIV test and STI screen, and a 6-monthly kidney function blood test and hepatitis status check. The Specialist GP reviews results, refills prescriptions, and discusses any side effects or changes at each follow-up. The monitoring routine is part of how PrEP stays safe and effective over time.
Side effects. Most people tolerate PrEP well. The most common early side effects are mild stomach symptoms (nausea, loose stools, headache) in the first 2 to 4 weeks. These usually settle without needing to stop. Less common but more important effects are a small reduction in kidney function (monitored every 6 months) and a small reduction in bone mineral density with long-term use (clinically significant only in people with other risk factors). Serious side effects are uncommon. The Specialist GP talks through what to expect and what to watch for.
What PrEP does NOT protect against. PrEP prevents HIV only. It does not protect against chlamydia, gonorrhoea, syphilis, mycoplasma genitalium, herpes, HPV, hepatitis A, or any other infection. For full sexual health protection, PrEP is often combined with condoms (still effective for other-STI prevention), regular STI screening (the quarterly screen above covers chlamydia, gonorrhoea, syphilis at minimum), and consideration of DoxyPEP for additional bacterial-STI protection in eligible groups.
If you have hepatitis B. The medication in PrEP also has activity against hepatitis B. This means that starting PrEP can suppress hepatitis B replication, and crucially, stopping PrEP suddenly in someone with chronic hepatitis B can cause a serious hepatitis flare. This is why hepatitis B status checking is part of the pre-start workup. If you have chronic hepatitis B, PrEP can still be started but the management plan is more careful, often with input from a hepatologist or infectious diseases physician. The Specialist GP can arrange this if needed.
PrEP in pregnancy. PrEP can be continued during pregnancy in women at ongoing HIV exposure risk. There is substantial real-world experience with PrEP in pregnancy and no signal of harm to the fetus or pregnancy. The medication does cross into breast milk in tiny amounts but is considered compatible with breastfeeding. The Specialist GP coordinates with your maternity care team for ongoing monitoring during pregnancy.
If you might have been exposed to HIV before starting PrEP. If you have had a possible HIV exposure within the last 72 hours, PEP (post-exposure prophylaxis) — not PrEP — is the right immediate option. PEP is a 28-day course that reduces the risk of HIV infection after exposure. Many people transition from PEP to PrEP after the PEP course completes if they have ongoing exposure risk. See emergency PEP for the 72-hour pathway.
How to start PrEP through Clinic365. The pathway: book a phone consult, the Specialist GP works through your situation and decides if PrEP is appropriate, baseline pathology tests are arranged (HIV, kidney function, hepatitis B and C, STI screen) at any pathology collection centre, once HIV-negative is confirmed the prescription is sent to your nominated pharmacy, and the first month's supply is collected and started. From booking to first dose is usually within a week. After that, quarterly review consultations keep the prescription, monitoring, and STI screening running. The whole pathway runs by phone — in-person visits are not required.
Cost. PrEP medication is listed on the Pharmaceutical Benefits Scheme (PBS) since April 2018 for eligible patients, with the standard PBS co-payment per month (concession rate available). Without PBS subsidy, the generic version has a separate pharmacy price. See our fees page for current Clinic365 consultation pricing. The monitoring pathology tests have Medicare item numbers that apply in most situations.
Confidentiality. PrEP prescribing is confidential. HIV is a notifiable condition only when diagnosed (not when PrEP is being used). The PrEP prescription appears as a PBS-listed medication on your pharmacy record; if you would prefer this not appear on your My Health Record, the Specialist GP can adjust settings at the consult.
Switching from another prescriber. If you are already on PrEP through another doctor, transferring care to a Specialist GP at Clinic365 is straightforward. The Specialist GP needs your recent monitoring results and any notes on your starting workup — mention this at the consult. There is no need to interrupt your PrEP regimen during the transfer.
Want to start or transfer? See the hero section above for booking. For Melbourne residents who want in-person, see PrEP in Melbourne. For the 72-hour after-exposure option, see emergency PEP. For bacterial STI prevention alongside PrEP, see DoxyPEP.
Frequently asked questions
Not sure when to test? See our When to Get an STI Test guide — how long after exposure to test, testing frequency, and what to do after exposure.
With consistent use, PrEP is more than 99 percent effective at preventing HIV infection. The high effectiveness depends on adherence — meaning the medication has to be in your system at adequate levels at the time of exposure. With consistent daily use the residual risk is very small. With imperfect adherence, the protection drops; this is why the Specialist GP discusses your pattern of risk and whether daily or on-demand dosing fits.
Daily PrEP is one tablet every day, regardless of sex. On-demand (2-1-1) PrEP is 2 tablets 2 to 24 hours before sex, 1 tablet 24 hours after, 1 tablet 48 hours after. On-demand is recommended only for men who have sex with men; for cis women and receptive vaginal sex, daily dosing is the only protocol with strong evidence. Daily PrEP is also generally simpler if you have sex more than 2 to 3 times a week. The Specialist GP discusses which option fits your pattern at the consult.
No — PrEP is taken during periods when you have ongoing HIV exposure risk. If your situation changes (a long-term mutually monogamous relationship with a partner of known HIV status, a long period without exposure, a change to safer practices), PrEP can be stopped. The Specialist GP discusses when to stop and how to manage the transition. If exposure risk returns later, PrEP can be restarted.
Usually within a week. The phone consult is typically available same-day. The baseline tests (HIV, kidney function, hepatitis B and C, STI screen) take 2 to 4 business days. Once HIV-negative is confirmed, the prescription is sent to your nominated pharmacy and you can start that day. For daily PrEP, full protection is generally reached after 7 days of daily use. For on-demand dosing, the loading dose of 2 tablets is what gets the medication to protective levels.
Most people tolerate PrEP well. The most common early side effects are mild stomach symptoms (nausea, loose stools, headache) in the first 2 to 4 weeks — these usually settle without needing to stop. Less common effects are a small reduction in kidney function (monitored every 6 months) and a small reduction in bone mineral density with long-term use (clinically significant only in people with other risk factors). Serious side effects are uncommon. The Specialist GP discusses what to expect.
No. PrEP prevents HIV only. It does not protect against chlamydia, gonorrhoea, syphilis, mycoplasma genitalium, herpes, HPV, or hepatitis. The quarterly STI screen that goes with PrEP catches bacterial STIs early so they can be treated. Condoms still play a role in other-STI prevention. For additional bacterial-STI prevention, see DoxyPEP.
Yes, but the management is more careful. The medication in PrEP also has activity against hepatitis B, so stopping PrEP suddenly in someone with chronic hepatitis B can cause a hepatitis flare. The pre-start workup includes hepatitis B status testing for this reason. If you have chronic hepatitis B, PrEP can still be started with input from a hepatologist or infectious diseases physician. The Specialist GP arranges this if needed.
PrEP is fully available by telehealth. The Specialist GP can do the initial consult, baseline workup interpretation, prescription, and ongoing quarterly reviews all by phone. The only in-person component is the pathology blood draws and sample collection, which happens at any pathology collection centre. In-person consults at our East Melbourne clinic are available for Melbourne residents who prefer face-to-face.
Yes — transferring care is straightforward. Bring (or arrange to share) your recent monitoring results and starting workup notes. There is no need to interrupt your PrEP during the transfer. The Specialist GP can pick up the monitoring schedule from where you left off and continue prescribing.
The medication is listed on the PBS since April 2018, with the standard PBS co-payment per month (concession rate is available). Without PBS subsidy, the generic version has a separate pharmacy price. See our fees page for current Clinic365 consultation pricing. The monitoring blood tests have Medicare item numbers that apply in most situations.
